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BRUCE STUART ALLEN M.D.
>> Dermatology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1558603969
Individual Registrant: BRUCE STUART ALLEN M.D.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1338 OLD FORSYTH RD MACON, GA 31210-7205 US
Tel: 478-471-7788 Fax: --
Tel: 478-471-7788 Fax: --
Contact information for business:
1338 OLD FORSYTH RD MACON, GA 31210-7205 US
Tel: 478-471-7788 Fax: --
Tel: 478-471-7788 Fax: --
Registration Information:
NPI: 1558603969
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207N00000X | Allopathic & Osteopathic Physicians Dermatology | GA | 20294 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| GEORGIA MEDICAL LICENCE NUMBER | 20294 | GA | 01 |
